Active NPI
Jennie Lacolla
- Occupational Therapist
- Bedford, MA
National Provider Identifier
1346821469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 13757
- Practice address
- 19 Crosby Dr Ste 140
Bedford, MA 01730-1401 - Phone
- (781) 245-4446
- NPI assigned
- Apr 20, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 13757 | MA | Primary |
Addresses
Primary practice location
19 Crosby Dr Ste 140
Bedford, MA 01730-1401
Mailing address
1 Harrison St
Stoneham, MA 02180-4351
Phone (781) 307-8117
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | jennielaco92@gmail.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13757 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1346821469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HARRISON ST",
"city": "STONEHAM",
"state": "MA",
"postal_code": "021804351",
"telephone_number": "781-307-8117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 CROSBY DR STE 140",
"city": "BEDFORD",
"state": "MA",
"postal_code": "017301401",
"telephone_number": "781-245-4446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACOLLA",
"first_name": "JENNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-20",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "13757",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "jennielaco92@gmail.com",
"affiliation": "N",
"address_1": "19 Crosby Dr Ste 140",
"city": "Bedford",
"state": "MA",
"country_code": "US",
"postal_code": "017301401",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.